Nearly 50 million lives saved since 2000; millions more can be saved by 2030: UNICEF

New-born shows an improving health status after being treated at Yekatit 12 Hospital Medical College, in Neonatal intensive care unit.
Premature newborn health is improving after being treated at Yekatit 12 Hospital Medical College, in Neonatal intensive care unit. Addis Ababa, Ethiopia ©UNICEF Ethiopia/2015/Mersha

NEW YORK/Addis Ababa, 9 September 2015 – The rate of decline in mortality among the world’s youngest children has more than doubled over a generation, and an additional 38 million lives could be saved by 2030 if progress accelerates further, in line with the Sustainable Development Goals (SDGs) world leaders are set to approve later this month.

Since 2000, when governments committed to achieving the Millennium Development Goals (MDGs), the lives of 48 million children under the age of five have been saved. This remarkable progress is the result of sustained action by leaders – to make saving children’s lives a policy and a political priority, to improve and use data about child survival, and to scale up proven interventions.

The number of children who die from mostly preventable causes before they turn five now stands at 5.9 million a year – a 53 per cent drop since 1990. At 3.9 percent the global annual rate of reduction of under-five mortality between 2000 and 2015 was more than twice as high as what it was in the 1990s.

Some of the world’s poorest countries have demonstrated that substantial reductions in child mortality can be achieved despite formidable obstacles:

  • 24 out of 81 low- and lower-middle income countries, including Cambodia, Ethiopia, Bangladesh and Uganda, achieved the MDG of reducing the under-five mortality rate by two-thirds or more.[1]
  • Between 2000 and 2015, twenty-one sub-Saharan African countries reversed a rising mortality trend or at least tripled their pace of progress compared to the 1990s.

Low income countries are: Cambodia, Ethiopia, Eritrea, Liberia, Madagascar, Malawi, Mozambique, Nepal, Niger, Rwanda, Uganda, and the United Republic of Tanzania. Lower-middle income countries are: Armenia, Bangladesh, Bhutan, Bolivia (Plurinational State of), Egypt, El Salvador, Georgia, Indonesia, Kyrgyzstan; Nicaragua; Timor-Leste; Yemen.

To reiterate the agenda, A Call to Action Summit took place from 27-28 August 2015 in New Delhi, India with the aim of ending preventable deaths of children and mothers by 2035. This was a prelude to the United Nations Summit for the adoption of post-2015 development agenda that will be held as a high-level plenary meeting of the UN General Assembly in September 2015.The two-day Leadership Summit was a confluence of health ministers from over 10 priority countries that committed to the global Call to Action for Child Survival in June 2012 including Ethiopia.

At the Summit, Ethiopia was represented by His Excellency Dr. Kesetebirhan Admasu accompanied by the technical team, including representatives from CSOs. In addition, Abelone Melese, UNICEF National Ambassador to Ethiopia, deliberated a speech and recited two songs entitled, “Welaj Enat” and “Happy Birthdays” to the participants of the Summit.

Dr. Kesete presented the progress accomplished by the Government of Ethiopia during the last decade and the new priorities- Ensuring “Quality” & Equity” in health care. He said, “The Government of Ethiopia is committed to end preventable maternal and child deaths. This will be possible through unwavering political commitment, community ownership, and universal health

coverage of high impact interventions. To consolidate the gains that were made during the MDGs and accelerate the progress towards the noble cause of ending preventable maternal and child deaths, the Ministry of Health has developed a 5-year-Health Sector Transformation Plan (HSTP) 2015-2020. The plan has set out ambitious goals to be achieved in this period. I would like to state four of the transformational agendas that were set out in this plan. Ensuring “Quality” & Equity” in health care: Equity and quality are the core goals of the health sector transformation plan, which aspires to build a high performing health system”.

UNICEF will continue to support the Government of Ethiopia to sustain the gains made on Child Survival and ensure that the unfinished business of neonatal and maternal mortality are rapidly addressed.

“Saving the lives of millions of children in urban and rural settings, in wealthy and poor countries, is one of the first great achievements of the new millennium — and one of the biggest challenges of the next 15 years is to further accelerate this progress” said UNICEF Deputy Executive Director Yoka Brandt. “The data tell us that millions of children do not have to die — if we focus greater effort on reaching every child.”

Simple, high-impact, cost effective solutions that contributed to this dramatic reduction of under-five deaths include skilled antenatal, delivery and postnatal care; breastfeeding; immunization; insecticide-treated mosquito nets; improved water and sanitation; oral rehydration therapy for diarrhoea; antibiotics for pneumonia; nutritional supplements and therapeutic foods.

Despite this impressive progress, the world has not met the MDG target of reducing under-five mortality by two-thirds.

Between 1990 and the end of 2015, an estimated 236 million children will have died from mostly preventable causes before turning five. Today, leading causes of under-five deaths include prematurity; pneumonia; complications during labour and delivery; diarrhoea; and malaria. Under-nutrition contributes to nearly half of all under-five deaths.

The SDGs challenge countries to significantly increase their efforts to bring rates of under-five mortality down to 25 deaths (or fewer) per 1,000 live births by 2030. By picking up the pace, especially in countries that are lagging, the world stands to save the lives of 38 million more children under the age of five.

About A Promise Renewed

Since its initiation in 2012, A Promise Renewed has focused on promoting the Millennium Development Goal (MDG) 4 of reducing the under-five mortality rate by two-thirds between 1990 and 2015, and continuing the effort until no child or mother dies from preventable causes. Partners that support A Promise Renewed have committed to five priority actions:

  1. Increasing efforts in the countries facing the greatest challenges on under-five mortality;
  2. Scaling up access to underserved populations everywhere;
  3. Addressing the causes that account for the majority of under-five deaths;
  4. Increasing emphasis on the underlying drivers of child mortality, such as women’s education and empowerment;
  5. Rallying around a shared goal and using common metrics to track progress.

Download the report

UNICEF, WHO: Lack of sanitation for 2.4 billion people undermining health improvements

A South Sudanese refugee takes a shower with water poured from a jerry can
A south Sudanese refugee Nvakuache Tut takes a shower by the way of water poured from a jerry can. 26, June 2014 Burbie South Sudanese Refugees Reception Centre Gambella Ethiopia. ©UNICEF Ethiopia/2014/Ayene

Final MDG progress report on water and sanitation released 

NEW YORK/GENEVA, 30 June 2015 – Lack of progress on sanitation threatens to undermine the child survival and health benefits from gains in access to safe drinking water, warn WHO and UNICEF in a report tracking access to drinking water and sanitation against the Millennium Development Goals.

The Joint Monitoring Programme report, Progress on Sanitation and Drinking Water: 2015 Update and MDG Assessment, says worldwide, 1 in 3 people, or 2.4 billion, are still without sanitation facilities – including 946 million people who defecate in the open. 

“What the data really show is the need to focus on inequalities as the only way to achieve sustainable progress,” said Sanjay Wijesekera, head of UNICEF’s global water, sanitation and hygiene programmes. “The global model so far has been that the wealthiest move ahead first, and only when they have access do the poorest start catching up. If we are to reach universal access to sanitation by 2030, we need to ensure the poorest start making progress right away.”

Access to improved drinking water sources has been a major achievement for countries and the international community. With some 2.6 billion people having gained access since 1990, 91 per cent of the global population now have improved drinking water – and the number is still growing. In sub-Saharan Africa, for example, 427 million people have gained access – an average of 47,000 people per day every day for 25 years.

The child survival gains have been substantial. Today, fewer than 1,000 children under five die each day from diarrhoea caused by inadequate water, sanitation and hygiene, compared to over 2,000 15 years ago.

On the other hand, the progress on sanitation has been hampered by inadequate investments in behaviour change campaigns, lack of affordable products for the poor, and social norms which accept or even encourage open defecation. Although some 2.1 billion people have gained access to improved sanitation since 1990, the world has missed the MDG target by nearly 700 million people. Today, only 68 per cent of the world’s population uses an improved sanitation facility – 9 percentage points below the MDG target of 77 per cent. 

“Until everyone has access to adequate sanitation facilities, the quality of water supplies will be undermined and too many people will continue to die from waterborne and water-related diseases,” said Dr Maria Neira, Director of the WHO Department of Public Health, Environmental and Social Determinants of Health. 

Access to adequate water, sanitation and hygiene is critical in the prevention and care of 16 of the 17 ‘neglected tropical diseases’ (NTDs), including trachoma, soil-transmitted helminths (intestinal worms) and schistosomiasis. NTDs affect more than 1.5 billion people in 149 countries, causing blindness, disfigurement, permanent disability and death.

The practice of open defecation is also linked to a higher risk of stunting – or chronic malnutrition – which affects 161 million children worldwide, leaving them with irreversible physical and cognitive damage.

“To benefit human health it is vital to further accelerate progress on sanitation, particularly in rural and underserved areas,” added Dr Neira.

Rural areas are home to 7 out of 10 people without access to improved sanitation and 9 out of 10 people who defecate in the open. 

Plans for the new Sustainable Development Goals to be set by the United Nations General Assembly in September 2015 include a target to eliminate open defecation by 2030. This would require a doubling of current rates of reduction, especially in South Asia and sub-Saharan Africa, WHO and UNICEF say. 

WHO and UNICEF say it is vitally important to learn from the uneven progress of the 1990-2015 period to ensure that the SDGs close the inequality gaps and achieve universal access to water and sanitation. To do so, the world needs:

  • Disaggregated data to be able to pinpoint the populations and areas which are outliers from the national averages;
  • A robust and intentional focus on the hardest to reach, particularly the poor in rural areas;
  • Innovative technologies and approaches to bring sustainable sanitation solutions to poor communities at affordable prices;
  • Increased attention to improving hygiene in homes, schools and health care facilities.

UNICEF signed Ethiopian Fiscal Year 2007 Work Plans with government. 

The signing ceremony of Ethiopian Fiscal Year 2007 Work Plans with government was held on Monday 30th June 2014 at the Intercontinental Hotel in Addis Ababa, facilitated by the Ministry of Finance and Economic Development (MoFED) of the Federal Democratic Republic of Ethiopia.

UN agencies signed Ethiopian Fiscal Year 2007 Work Plans with government.
From right to left: Mr. Faustin Yao Representative of UNFPA in Ethiopia, Dr. Peter Salama, UNICEF Representative in Ethiopia, Mr. Eugene Owusu – UN resident coordinator and H.E. Mr. Ahmed Shide State Minister of Finance and Economic Development, Federal Democratic Republic of Ethiopia. During the signing ceremony of Ethiopian Fiscal Year 2007 Work Plans ©UNICEF Ethiopia/2014/Sewunet

Speaking during the signing ceremony, Ato Ahmed Shide, State Minister of Finance and Economic Development said that “the support rendered through the AWPs will be instrumental for the successful implementation of the current Growth and Transformation Plan (GTP) of the Government as well as the next generation of the plan.” The Resident Coordinator of the UN Country Team in Ethiopia, Mr. Eugene Owusu, affirmed speaking on behalf of the UN Agencies that efforts and collaborations will be sustained at a continued scale during the coming years of the next UNDAF period.

Regional Implementing Partners and UN agencies including UNFPA, UNDP, UN Women, ILO and WFP were present as signatories.  Annual Working Plans (AWP) are prepared every two year following the Ethiopian Fiscal Year.  The preparation process starts in early March and follows a consultative approach at the regional and federal level.

 

38,000 health extension workers bring health services to the doorstep of rural Ethiopians

By Sacha Westerbeek

Ethiopia, 2012. A young girl in the arms of her caregiver – interacting with UNICEF’s Sacha Westerbeek and Health Extension worker in Romey Village, North Shoa Zone, Amhara Region. Photo credit: UNICEF Ethiopia/2012/Getachew

Even before I joined UNICEF Ethiopia in June 2011, I had heard about its impressive health extension programme: health care is decentralised and over 30,000 health workers are deployed throughout the country and on Government payroll. A great story to tell!

By now, I’ve visited many health posts, run by these amazing women, generally in their early twenties from rural communities, dynamic and dedicated. Being educated and given the opportunity to work in their community, you can really see how this transforms their lives and status within the society in addition to the gains made in terms of health care. When one speaks about health in Ethiopia, I think about the health extension workers. To me, these young women represent the true heroes, or more precisely heroines, and one of the reasons why Ethiopia is doing so well in terms of its health indicators.

“Ethiopia Achieves the Child Survival Millennium Development Goal (MDG), three years ahead of time.” If you don’t follow global health debates closely, you may have missed this news, which broke the news in September 2013 and seriously hit the roofs in this nick of the woods.

Ethiopia, 2012. Health Extension Worker Haimanot Hailu and her partner walk through Romey Kebele (sub-district) North Shoa Zone, Amhara Region, for home visits carrying vaccine carriers. ©UNICEF Ethiopia/2012/Getachew

How did this happen in terms of policy choices? Around ten years ago, in order to address the increasing urban-rural gap in access to health services, the Government of Ethiopia launched the Health Extension Programme (HEP). This package of interventions was carefully tailored to the major causes of childhood mortality and morbidity – the epidemiology determined the priorities. The early years were not easy and, at several junctures, the system almost collapsed under the weight of expectations and the urgent imperative of delivering services to more than 80 million people in a vast and diverse country. And yet, every year, starting from a focus on basic prevention (insecticide treated nets, vaccination), the system has become stronger and stronger. Incrementally, best practice in curative-oriented, primary health care from around the world has been integrated into the HEP. So too has a multi-sectoral agenda that attempts to address root causes of childhood disease, such as food and nutrition security and water and sanitation. Community-based treatment of diarrhoea, pneumonia, malaria, severe acute malnutrition and, most recently, new-born sepsis and the inclusion of new vaccines, are all now central components.

Today, 38,000 health extension workers are deployed bringing health services to the doorstep of its rural people with real resources – becoming the cornerstone of the health system. Through my visits throughout this enormous country, I can see that the programme is sustainable and that the bilateral government donors, the World Bank and UN agencies, NGOs and civil society, philanthropic foundations, and the private sector, have all played a key role through their funding, their programmatic, operational and technical assistance, and their belief that Ethiopia could achieve the goals. Ethiopia could not have done this alone.

Read the full article here

Ethiopia to second health professionals, experts and health professionals to Namibia

The Namibian government on Wednesday signed a Memorandum of Understanding (MoU) with Ethiopia whereby both parties agreed on the possibility for Ethiopia to second health professionals, experts and health professionals to Namibia.

Health extension worker Bruktawit Mulu

In terms of the MoU Ethiopia has committed to continue providing scholarships to a specified number of Namibian students to go and study in that country. The two countries further agreed on a training programme for Namibian health professionals, including doctors, registered nurses, health technicians, pharmacists, paramedics and others. During the signing ceremony the Minister of Health and Social Services, Dr Richard Kamwi, once again reiterated that Namibia faces a critical shortage of health professionals and stressed the fact that the ministry finds it difficult to attract and retain health professionals in rural areas.

Early in March Cabinet decided that the health extension programme should be introduced in all regions. Shortly thereafter the Ethiopian ministry of health assisted Namibia to pilot the health extension workers programme in the Kunene Region through which about 40 Namibians were trained. The health extension programme was then rolled out to the Zambezi, Kavango East and Kavango West, Ohangwena, Omusati and Kunene regions where a total of 565 health extension workers are currently undergoing training. The health extension workers act as a bridge between the community and public health care clinics.

They also promote health and educate people on how to prevent diseases in communities, as well as promote immunisation and carry out maternal and child health assessments. Moreover, the Ethiopian Minister of Health, Dr Kesetebirhan Admasu revealed that his country made a significant effort to improve health delivery. Admasu said Ethiopia has already achieved targets on combating HIV/AIDS, malaria and other diseases and also reduced its under-five mortality rate by two thirds between 1990 and 2012, thereby meeting the target set under the Millennium Development Goals. Read more